7 Arizona doctors lose Medicaid contracts

AHCCCS dismissals come amid prescription probe

The state's Medicaid program said it has terminated the contracts of seven doctors who were top prescribers of powerful pain pills and mental-health prescription drugs.

Their dismissals were made public as the result of an ongoing probe by U.S. Sen. Charles Grassley, R-Iowa, of drug-prescribing patterns in Medicaid programs across the country. Medicaid programs, which provide health care to the nation's poor, reimburse doctors and practitioners. Grassley's probe centers on health-care professionals who prescribe large amounts of pain pills and psychiatric drugs.

Of the seven doctors terminated from the Arizona Health Care Cost Containment System, Arizona's Medicaid program, two faced criminal charges in connection with their prescribing patterns, three relinquished their medical licenses and two no longer treat Medicaid patients, prompting AHCCCS to terminate their contracts due to inactivity over a 24-month period.

In an April 3 letter to Grassley, AHCCCS Director Thomas Betlach highlighted his agency's efforts to participate in a multi-agency investigation of Dr. Angelo Chirban, the Arizona Medicaid program's most prolific prescriber of the pain pills oxycodone and OxyContin over fiscal 2008 and 2009.

Chirban and his ex-wife were charged in U.S. District Court in December with 130 counts in connection with writing thousands of prescriptions for oxycodone and other pain medications for non-medical reasons.

Grassley earlier questioned AHCCCS' efforts to ferret out fraud, waste and abuse as the agency spends $650 million each year on prescription drugs for Medicaid recipients. In a January letter to Betlach, Grassley said he had "concerns about the oversight and enforcement of Medicaid abuse in your state."

Two years ago, Grassley requested that Arizona's Medicaid program provide data on the top prescribers of common painkillers oxycodone, OxyContin and Roxicodone, as well as six anti-anxiety and mental-health drugs for fiscal 2008 and 2009.

The Iowa Republican made similar inquiries to all state Medicaid programs to bring attention to the potential of fraud and abuse in prescribing patterns.

Grassley has since requested -- and received from Arizona -- the top prescribers of those drugs for fiscal 2010 and 2011. He also asked Betlach one dozen questions about AHCCCS' efforts to curb excessive prescription writing.

Betlach said that the top prescribers of the mental-health drugs represented less than 2 percent of AHCCCS' total prescription costs for 2010 and 2011.

He noted the mental-health drugs are prescribed for the 122,000 Arizonans enrolled in the state's behavioral health-services program, and of those, 20 percent are adults diagnosed with serious mental illness and 32.5 percent are children or adolescents.

Only one of the seven doctors whose license was terminated was a psychiatrist. Jennifer Suzanne Gunther, a Tucson psychiatrist, said she no longer treats Medicaid patients in her new position with the Veterans Administration. AHCCCS terminated Tucson pain-management physician Susan B. Fleming's license because she no longer treats Medicaid patients.

Lloyd David Armold, a Tucson osteopathic physician, surrendered his license in 2010 after the Arizona Board of Osteopathic Examiners restricted his ability to prescribe hydrocodone and morphine. Armold said the "board was bugging me for doing alternative medicine," so he decided to retire.

Erol LeBlanc, a family practice doctor, had his license revoked by the Arizona Board of Osteopathic Examiners in September, the board's records show. Tucson physician Margarita Martinez, who could not be reached, relinquished her license in 2009.

AHCCCS also terminated its contract with Albert Yeh, a Golden Valley physician who pleaded guilty in January 2011 to three felonies and was sentenced to 21/2 years in prison and five years' probation. He surrendered $2 million in cash and agreed to pay more than $683,000 in restitution to AHCCCS.